Incisäo de gibson na linfadenectomia ílio-inguinal / Gibson's incision for ilio-inguinal lymphadenectomy

RESUMO

Squamous cell carcinoma of the penis usually metastasizes to the inguinal and iliac regions through the lymphatic channels. Early prophylactic lymphadenectomy in patients with invasive penile carcinoma result in better survival when compared with delayed or therapeutic lymphadenectomy. Skin flap necrosis is the most common complication associated with ilio-inguinal limphadenectomy. The author describes the ilio-inguinal lymphadenectomy using the Gibson incision for patients with squamous cell carcinoma of penis. This incision of the abdominal wall provides excellent exposure of the iliac vessels when the peritoneum is retracted medially. After groin dissection, transplantation of the sartorius muscle is not necessary. When we use the Gibson incision the incidence of flap necrosis is low because the incision is performed in the superior margin of the dissection. The superior flap is always viable and we do not need to perform further complementary distal incision. In our experience, patients who underwent lymphadenectomy concomitantly with penile suegery had better prognosis than those who underwent delayed lymphadenectomy